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Microelectrode Guided Implantation of Electrodes into the Subthalamic Nucleus of Rats for Long-term Deep Brain Stimulation
Published on: October 2, 2015
Bilateral subthalamic deep brain stimulation using single track microelectrode recording
Won Seok Chang1, Hae Yu Kim, Joo Pyung Kim
1Department of Neurosurgery, Yonsei University College of Medicine, 205 Seongsanno Seodaemun-gu, Seoul, 120-752, Korea.
Acta Neurochirurgica
|February 12, 2011
Summary
Single-track microelectrode recording (MER) during deep brain stimulation (DBS) for Parkinson's disease offers accurate electrode placement. The risk of intracranial hemorrhage is minimal with careful monitoring, especially in elderly patients.
Area of Science:
- Neurosurgery
- Neurology
- Medical Devices
Background:
- Microelectrode recording (MER) is crucial for deep brain stimulation (DBS) to identify brain structures and guide electrode placement.
- However, MER carries a risk of intracranial hemorrhage.
Purpose of the Study:
- To evaluate the accuracy of single-track MER for electrode positioning during subthalamic nucleus (STN) DBS.
- To assess the risk of intracranial hemorrhage associated with single-track MER.
Main Methods:
- 46 electrodes were placed in 23 Parkinson's disease patients using single-track MER for STN DBS.
- Electrode accuracy and frontal air thickness were measured using MRI.
- Pre- and postoperative Unified Parkinson's Disease Rating Scale (UPDRS) scores and levodopa equivalent dosages (LED) were assessed.
Main Results:
- Mean electrode positioning error was 0.92 mm, with frontal air thickness not significantly affecting accuracy.
- Nine electrodes required repositioning due to microstimulation effects or observed short STN length during MER.
- One patient experienced an intracranial hemorrhage, likely due to venous infarction, not directly related to MER.
Conclusions:
- Single-track MER allows for acceptable electrode accuracy in STN DBS.
- Multi-track MER may elevate the risk of intracranial hemorrhage compared to single-track MER.
- The risk of hemorrhage is minimal with careful monitoring, particularly in elderly patients with brain atrophy.
